Cell-based Therapies for Acute Respiratory Distress Syndrome: where are we now?

Abstract

Cell-based therapies, particularly mesenchymal stromal cells (MSCs) and their products, have considerable therapeutic potential for patients with ARDS. MSCs exert their effects via diverse mechanisms including reducing excessive inflammation by modulating neutrophil, macrophage and T-cell function, decreasing pulmonary permeability and lung edema, and promoting tissue repair. Across the spectrum of clinical disorders, there are over 1,000 clinical trials of MSCs registered on Clinicaltrials.gov, with just over 300 clinical trials published to date. Overall, MSCs have exhibited an acceptable safety profile and demonstrated promising therapeutic benefits in specific clinical settings, which has led to regulatory approvals of MSCs for specific indications (e.g. graft versus host disease, Crohn’s fistulae), in a small number of countries worldwide. 
In this talk, the therapeutic potential of MSC-based therapies for ARDS will be critically appraised. Results from recent cell therapy trials in both COVID-19 and in ‘classic’ ARDS will be discussed. Key unknowns and gaps in the current literature, and challenges to clinical translation of MSC-based therapies will be discussed.

About the speaker

John Laffey is Professor of Anesthesia and Critical Care Medicine at the University of Galway, Ireland. He is Director of Clinical Research at University of Galway and the Saolta University Hospital Group, and the director of the Lung Biology research group at the University of Galway. Past roles include Chair of the Irish Critical Care Trials Group, and Section Chair of the Translational Biology Section at the European Society of Intensive Care Medicine.
His research is focused on ARDS and sepsis, particularly the mechanisms underlying lung and systemic organ injury. He has a longstanding interest in the investigation of the mechanisms of action and therapeutic potential of cell therapies for critical illnesses. Other interests include the epidemiology of ARDS and weaning from mechanical ventilation. He has extensive experience of early phase and later phase clinical trials.